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    Current Customs Broker Application

    Uploaded by

    Jon JOnes
    This document is an application for a customs broker's license in Belize. It requests information such as the applicant's name, address, date of birth, education history, and employment details. It also requires the applicant to declare that they have not been indicted of any dishonest offenses in the past 5 years. The completed application needs to be submitted along with supporting documents and a $50 application fee to the Customs Brokers and Customs Clerks Board in Belize City.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Current Customs Broker Application

    Uploaded by

    Jon JOnes
    41 views3 pages
    This document is an application for a customs broker's license in Belize. It requests information such as the applicant's name, address, date of birth, education history, and employment details. It also requires the applicant to declare that they have not been indicted of any dishonest offenses in the past 5 years. The completed application needs to be submitted along with supporting documents and a $50 application fee to the Customs Brokers and Customs Clerks Board in Belize City.

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    This document is an application for a customs broker's license in Belize. It requests information such as the applicant's name, address, date of birth, education history, and employment details. It also requires the applicant to declare that they have not been indicted of any dishonest offenses in the past 5 years. The completed application needs to be submitted along with supporting documents and a $50 application fee to the Customs Brokers and Customs Clerks Board in Belize City.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    41 views3 pages

    Current Customs Broker Application

    Uploaded by

    Jon JOnes
    This document is an application for a customs broker's license in Belize. It requests information such as the applicant's name, address, date of birth, education history, and employment details. It also requires the applicant to declare that they have not been indicted of any dishonest offenses in the past 5 years. The completed application needs to be submitted along with supporting documents and a $50 application fee to the Customs Brokers and Customs Clerks Board in Belize City.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Tel: +(501) 671-2601

    Customs & Excise Headquarters


    Caesar Ridge Rd, Belize City
    [email protected]

    GST TIN:____________

    APPLICATION FOR A CUSTOMS BROKER’S LICENCE

    Complete all sections as fully as possible and attach supplementary sheets, where necessary.

    Completed application form, and supporting documentation (Police record, Company registry
    certificate), together with the bank deposit receipt of appropriate application fee ($50.00), should be
    submitted in duplicate to the Secretary of the Board, Customs Brokers and Customs Clerks Board,
    Customs House, Belize City, Belize. Bank Deposit must be made at Atlantic Bank A/c #
    100305493 in the name of CUSTOMS BROKERS AND CUSTOMS CLERKS BOARD.

    1. Name of applicant:

    __________________________________________________________________________
    (Given name) (Surname) (Any other names)

    2. Registered Business Address:

    _________________________________________________________________________

    3. Contact details:

    Tel:______________ Mobile #:______________ E-mail:_______________________

    4. Date of birth: ____/_____/_________


    dd / mm / year

    5. Place of birth: ____________________________________________


    (Attach a certified copy of the birth certificate or other form of identification)

    6. Are you a resident of Belize or CARICOM?

    ( ) Yes ( ) No

    If ‘No”, state your place of residence


    ________________________________________________________

    7. School/College attended ____________________________________


    Certificate/Degree awarded _________________________________
    Graduate studies ___________________________________________

    Certificate/Degree awarded ___________________________________

    Others ____________________________________________________

    ____________________________________________________

    ____________________________________________________
    (Continue on a separate sheet, if necessary)

    8. State present employment

    DATE EMPLOYER AND ADDRESS POSITION HELD

    __________________________________________________________

    __________________________________________________________

    9. I give permission to contact my present employer.


    ( ) Yes ( ) No

    10. Have you been indicted of an offence involving dishonesty during the past five (5) years,
    whether in Belize or elsewhere?

    ( ) Yes ( ) No

    If “Yes”, give details.


    ________________________________________________________

    ________________________________________________________

    Dated this _______ day of _____________ 20______

    I hereby declare under penalty of perjury that I am acting on my own behalf, and that the
    foregoing statements are true and correct to the best of my knowledge and belief.

    _____________________
    (Signature of Applicant)

    Customs Brokers & Customs Clerks Board 4/2019


    I, _____________________________, of ______________________________________ and
    (Name of Justice of Peace / Notary Public) (Home address)

    currently employed as ________________________ hereby declare that I have been


    (Profession)

    acquainted with the applicant _____________________________ for the past


    ( Applicant’s full name)

    __________ years through ________________________________ and that the


    (number of years) (Relationship to Applicant)

    information provided in this application is true and correct to the best of my knowledge,
    information and belief.

    Subscribed and sworn to before me this_______ day of _____________ 20______

    SEAL _________________________________
    Justice of the Peace or Notary Public

    Customs Brokers & Customs Clerks Board 4/2019

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